Tuesday, June 05, 2012

Four Questions for Insurance Companies–Re: Private Equity Dentistry

It’s getting about time these Malpractice Insurance companies as well as insurance companies such as United Concordia and Guardian answer some questions. I just have three:

1.Why are you knowingly ( and you damn well know it) providing malpractice insurance to illegal operations?

Has no one in the Insurance company ever questioned why they are selling malpractice insurance to a company with 500 dentists working for it? The fact you do it, means you know it.

Yet, when malpractice cases come a callin’ you don’t want to pay up. But you damn well didn’t mind to take the premiums all these years, now did you?

2. Why are you sending patients to dentists who are practicing dentistry illegally?

It’s beyond me why I pay a weekly (however minimum) premium for dental coverage through employment. I am covered with Guardian. I find the name alone highly misleading, since guarding is not even near the top of their to do list.

I recently did a 50 mile radius search of providers on their website for myself. I was excited to see there were four pages -triple columns- listing a 103 dentists in my area. Then I actually read them.

Only one locally owned and operated clinic was listed! ONLY ONE! . I don’t live in a big city, but it’s not small either, somewhere around 60 thousand. There were 5 dentists listed in surround counties that were between 30 and 40 more miles away. FIVE!

That leaves 97 names on the list. Of those 97 names, everyone on of them were duplicated at least once and some three times. Where were they and who were they?

They all worked for Aspen Dental. There are three Aspen Dental clinics in that 50 mile radius. Two in once city across the river in Indiana. Every licensed denitst who works for Aspen Dental in the whole state of Indiana was listed as a provider at the two clinics within my radius. You can bet 99% of them have never seen inside the clinics close to me, and work in other Aspen clinics throughout the state. Yet there names were listed as though I could actually call up the clinics close to me and make an appointment with any of them.

I can’t call up the clinic and make an appointment with the dentist, I am making the appointment with the CLINIC, and the clinic is operating illegally!

The dentists who were on the list three times, were regional managers, so their names would be associated with the two clinics across the river and the one Aspen clinic here. One of them lives in Ohio for God’s sake! He damn well doesn’t see patients! Yes, he has a dental license in KY so he made the list of “providers” I can make an appointment to see, according to Guardian, that is.

3.Do you have any system in place to see that you aren’t being fraudulently billed?

Just as an example, have you ever noticed that dentists who work for these private equity backed dental clinics seem to get worse at their abilities the longer they are with the companies?

Let’s say a new dentist comes on board. This one bills for simple extractions, however the other dentist, who has been at the place a long time, can’t do a simple extraction (D7140) to save their lives, only surgical ones (D7210) which pays somewhere around double?

Hint: There may be fraud! The new guys aren’t so comfortable with fraudulent billing as the more seasoned veterans of the trade.

4. Why are you not being held liable?

You are complicit in the malpractice and mistreatment as well as the crime.

In conclusion, all dentists should be highly pissed off about this. Especially number 3.

While reimbursement rates are being cut, could it be, that would not be happening, if your fellow dentistss on corporate payrolls were not stealing as much as they can to make their daily “quota” and weekly bonus goals?